Diagnostic accuracy of different imaging modalities following computed tomography (CT) scanning for assessing the resectability with curative intent in pancreatic and periampullary cancer

Tamburrino, Domenico; Riviere, Deniece; Yaghoobi, Mohammad; Davidson, Brian R; Gurusamy, Kurinchi Selvan

doi:10.1002/14651858.cd011515.pub2

Cited by 37 publications

(31 citation statements)

References 163 publications

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“…3 Routine preoperative workup includes computed tomography (CT) to evaluate local resectability and to exclude disseminated disease. 4 Despite this, in approximately 10-25% of patients, locally advanced disease or occult distant metastases are identified during exploratory laparotomy. 5 Staging laparoscopy (SL) may decrease the rate of futile operations in those found to have resectable disease on CT. 5,6 SL can be combined with laparoscopic ultrasound (LUS) to allow a detection of occult liver metastases missed by preoperative CT. Due to the improvement of imaging techniques over the last decade, however, the value of LUS in addition to SL and preoperative CT may have diminished.…”

Section: Introductionmentioning

confidence: 99%

The Additional Value of Laparoscopic Ultrasound to Staging Laparoscopy in Patients with Suspected Pancreatic Head Cancer

Looijen

Pranger

Jong

et al. 2018

Journal of Gastrointestinal Surgery

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Background This study aimed to evaluate the additional value of laparoscopic ultrasound (LUS) to staging laparoscopy (SL) for detecting occult liver metastases in patients with potentially resectable pancreatic head cancer. Methods A retrospective cohort study was performed including all patients who underwent SL and LUS between 2005 and 2016. LUS was performed during SL to detect liver metastases not found by preoperative imaging or visual inspection of the liver. Results Out of 197 patients, visual inspection during SL detected distant metastases in 29 (14.7%) patients. LUS was performed in 127 patients, revealing 3 additional liver metastases. The proportion of patients with unresectable disease after SL and negative LUS was 32.3%, which was similar to 36.6% of patients with unresectable disease after SL without LUS (difference 4.3%; 95% CI − 13-23%; P = 0.61). Sensitivity, specificity, and positive and negative predictive values of LUS to detect liver metastases were 30, 100, 100, and 94%, respectively. The proportion of patients with distant metastases diagnosed at SL significantly increased over time (P = 0.031). Conclusion The routine use of LUS during SL for patients with potentially resectable pancreatic head cancer cannot be recommended. Imaging should be repeated when significant delay occurs between index CT and the scheduled surgery.

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Section: Introductionmentioning

confidence: 99%

The Additional Value of Laparoscopic Ultrasound to Staging Laparoscopy in Patients with Suspected Pancreatic Head Cancer

Looijen

Pranger

Jong

et al. 2018

Journal of Gastrointestinal Surgery

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“…[6] In a recent meta-analysis, Tamburrino and colleagues [8] demonstrated that EUS is 0.87 sensitive and 0.80 specific for identifying unresectable disease in patient who were believed to have resectable pancreatic adenocarcinoma after a CT scan was performed.…”

Section: Introductionmentioning

confidence: 99%

The incremental benefit of EUS for identifying unresectable disease among adults with pancreatic adenocarcinoma: A meta-analysis

et al. 2017

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Background and study aimsIt is unclear to what extent EUS influences the surgical management of patients with pancreatic adenocarcinoma. This systematic review sought to determine if EUS evaluation improves the identification of unresectable disease among adults with pancreatic adenocarcinoma.Patients and methodsWe searched MEDLINE, EMBASE, bibliographies of included articles and conference proceedings for studies reporting original data regarding surgical management and/or survival among patients with pancreatic adenocarcinoma, from inception to January 7th 2017. Our main outcome was the incremental benefit of EUS for the identification of unresectable disease (IBEUS). The pooled IBEUS were calculated using random effects models. Heterogeneity was explored using stratified meta-analysis and meta-regression.ResultsAmong 4,903 citations identified, we included 8 cohort studies (study periods from 1992 to 2007) that examined the identification of unresectable disease (n = 795). Random effects meta-analysis suggested that EUS alone identified unresectable disease in 19% of patients (95% confidence interval [CI], 10–33%). Among those studies that considered portal or mesenteric vein invasion as potentially resectable, EUS alone was able to identify unresectable disease in 14% of patients (95% CI 8–24%) after a CT scan was performed.LimitationsThe majority of the included studies were retrospective.ConclusionsEUS evaluation is associated with increased identification of unresectable disease among adults with pancreatic adenocarcinoma.

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“…Because of its safety, noninvasive nature, and high‐quality soft‐tissue contrast, MRI has become an important method for detecting pancreatic lesions . We previously found that the development and application of iterative decomposition of water and fat with echo asymmetry and least‐squares estimation quantitation (IDEAL‐IQ) sequences provided a useful technique for evaluating pancreatic lesions .…”

mentioning

confidence: 99%

“…Because of its safety, noninvasive nature, and high-quality soft-tissue contrast, MRI has become an important method for detecting pancreatic lesions. [11][12][13][14] We previously found that the development and application of iterative decomposition of water and fat with echo asymmetry and least-squares estimation quantitation (IDEAL-IQ) sequences provided a useful technique for evaluating pancreatic lesions. [15][16][17][18] However, thus far few studies have described a pathological comparison between the adipose component measured by the IDEAL-IQ sequence and the actual degree of fat infiltration of the pancreas in T2DM.…”

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confidence: 99%

Magnetic resonance imaging: Proton density fat fraction for assessment of pancreatic fatty infiltration during progression of T2DM bama minipigs

Chen

Jiang

Miu

et al. 2019

Magnetic Resonance Imaging

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Background Recent studies have highlighted the correlation between diabetes and pancreatic fat infiltration. However, pancreatic fat content (PFC) is rarely confirmed by pathological results, and a change of PFC during progression of type 2 diabetes (T2DM) is currently controversial. Purpose To evaluate the relationship of MRI‐pancreatic proton density fat fraction to serologic changes and histology in an experimental model of diabetes. Study Type Prospective animal study. Animal Model Thirteen Bama pigs were randomly assigned to diabetes (n = 7) or control (n = 6) groups. Pigs in the diabetic group received high‐fat/high‐sugar feed, combined with three doses of streptozotocin injections. Field Strength/Sequence 3.0T, IDEAL‐IQ sequence. Assessment Starting in the fifth month, biochemical changes were evaluated; all pigs underwent axial MRI with the IDEAL‐IQ sequence to measured pancreatic fat fraction (PFF). PFC was measured by the Soxhlet extraction method. Pancreatic fat distribution and pancreas islet morphology were observed by histopathology. Statistical Tests A Mann–Whitney U‐test, independent‐samples t‐test, Pearson correlation, Spearman correlation, single‐measure intraclass correlation coefficient (ICC) were performed. Results During the development of T2DM, the PFF, weight, fasting blood glucose (FBG), triglyceride (TG), total cholesterol (TCHO), low‐density lipoprotein (LDL), and HOMA‐IR (insulin resistance) of the experimental group showed an upward trend; fasting insulin (INS), high‐density lipoprotein (HDL), and HOMA‐β showed decreasing trends. At the end of the fifteenth month, FBG (mmol/L) was 18.06 ± 6.03 and 5.06 ± 1.41 (P < 0.001), PFF (%) was 36.52 ± 4.07 and 27.75 ± 3.73 (P = 0.002), INS (mU/L) was 21.59 ± 2.93 and 29.32 ± 3.27 (P = 0.001), HOMA‐IR was 16.83 ± 4.22 and 6.70 ± 2.45 (P < 0.001), HOMA‐β was 1.50 ± 0.24 and 2.77 ± 0.45 (P < 0.001), between the experimental and control groups. There were strong and moderate positive correlations between PFF and PFC (r = 0.968, P < 0.001), and FBG (r = 0.657, P = 0.015), and HOMA‐IR (r = 0.608, P = 0.028). Data Conclusion MRI‐proton density fat fraction can measure the fat content of the pancreas with great accuracy and repeatability; PFF is a potential biomarker that can reflect the different stages of diabetes development. Level of Evidence: 2 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2019;50:1905–1913.

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Diagnostic accuracy of different imaging modalities following computed tomography (CT) scanning for assessing the resectability with curative intent in pancreatic and periampullary cancer

Abstract: Diagnostic accuracy of different imaging modalities following computed tomography (CT) scanning for assessing the resectability with curative intent in pancreatic and periampullary cancer.

Cited by 37 publications

References 163 publications

The Additional Value of Laparoscopic Ultrasound to Staging Laparoscopy in Patients with Suspected Pancreatic Head Cancer

The Additional Value of Laparoscopic Ultrasound to Staging Laparoscopy in Patients with Suspected Pancreatic Head Cancer

The incremental benefit of EUS for identifying unresectable disease among adults with pancreatic adenocarcinoma: A meta-analysis

Magnetic resonance imaging: Proton density fat fraction for assessment of pancreatic fatty infiltration during progression of T2DM bama minipigs

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